Ukufakelwa Kwemathambo

-Delile

• Kungani Ungadinga Ukufakelwa Komongo Wethambo
• Yiziphi izingqinamba ezihambisana nokufakelwa kabusha kwe-Bone Marrow?
• Izinhlobo Zokufakelwa Kwethambo Lamathambo
• Ukufakelwa kwe-Autologous
• Ukufakelwa kwe-Allogeneic
• Ungakulungiselela Kanjani Ukufakelwa Umongo Wethambo
• Kwenziwa Kanjani Ukufakelwa Komongo Wethambo
• Leukapheresis
• Yini Ongayilindela Ngemuva Kokufakelwa Komongo Wethambo

Kuyini ukufakelwa Umongo Wethambo?

Ukufakelwa komnkantsha kuyinqubo yezokwelapha eyenzelwa ukubuyisela umnkantsha wethambo owonakele noma obhujiswe izifo, ukutheleleka noma i-chemotherapy. Le nqubo ifaka ukufakelwa amangqamuzana egazi, ahambela emnkantsheni wamathambo lapho akhiqiza khona amangqamuzana egazi amasha futhi akhuthaze ukukhula komnkantsha omusha.

Umnkantsha wamathambo yisiponji, izicubu ezinamafutha ngaphakathi kwamathambo akho. Kwakha izingxenye ezilandelayo zegazi:

• amangqamuzana abomvu egazi, athwala umoya-mpilo nezakhi zomzimba emzimbeni
• amangqamuzana amhlophe egazi, alwa nokutheleleka
• ama-platelet, anesibopho sokwakhiwa kwamahlule

Umnkantsha wethambo uqukethe nama-stem cell angavuthwanga akha igazi abizwa ngama-hematopoietic stem cells, noma ama-HSCs. Amaseli amaningi asehlukanisiwe futhi angenza amakhophi awo kuphela. Kodwa-ke, lawa maseli we-stem awaziwa, okusho ukuthi anamandla okwanda ngokuhlukaniswa kwamaseli futhi angahlala amaseli ama-stem noma ahlukanise futhi avuthwe abe yizinhlobo eziningi zamaseli egazi. I-HSC etholakala emnkantsheni wethambo izokwakha amangqamuzana egazi amasha kuyo yonke impilo yakho.

Ukufakelwa komnkantsha esikhundleni samaseli akho omzimba owonakele ngamaseli anempilo. Lokhu kusiza umzimba wakho ukwenza amaseli egazi amhlophe anele, amaplatelets, noma amaseli abomvu egazi ukugwema ukutheleleka, ukuphazamiseka kokopha, noma i-anemia.

Amaseli ezinhlanga anempilo angavela kumnikeli, noma angavela emzimbeni wakho. Ezimweni ezinjalo, amaseli ama-stem angavunwa, noma akhuliswe, ngaphambi kokuba uqale ukwelashwa ngamakhemikhali noma ukwelashwa ngemisebe. Lawo maseli aphilile ayagcinwa futhi asetshenziselwe ukufakelwa kabusha.

Kungani Ungadinga Ukufakelwa Komongo Wethambo

Ukufakelwa komnkantsha wethambo kwenziwa lapho umnkantsha womuntu ungaphilile ngokwanele ukuthi usebenze kahle. Lokhu kungabangelwa ukutheleleka okungamahlalakhona, izifo, noma ukwelashwa komdlavuza. Ezinye izizathu zokufakelwa komnkantsha wamathambo zifaka:

• i-aplastic anemia, okuyisifo lapho umnkantsha uyeka ukwenza amangqamuzana egazi amasha
• umdlavuza othinta umnkantsha, njenge-leukemia, i-lymphoma, ne-myeloma eminingi
• umongo wethambo owonakele ngenxa yokwelashwa ngamakhemikhali
• i-congenital neutropenia, okuyisifo esizuzwe njengefa esidala izifo eziphindaphindayo
• i-sickle cell anemia, okuyisifo segazi esizuzwe njengefa esidala ukwakheka okungafani kwamangqamuzana abomvu egazi
• i-thalassemia, okuyisifo segazi esizuzwe njengefa lapho umzimba wenza uhlobo olungajwayelekile lwe-hemoglobin, ingxenye ebalulekile yamaseli abomvu egazi

Yiziphi izingqinamba ezihambisana nokufakelwa kabusha kwe-Bone Marrow?

Ukufakelwa komnkantsha ithathwa njengenqubo enkulu yezokwelapha futhi kwandisa ubungozi bokuhlangabezana:

• ukwehla komfutho wegazi
• ikhanda elibuhlungu
• isicanucanu
• ubuhlungu
• ukuphelelwa umoya
• Ukugodola
• umkhuhlane

Izimpawu ezingenhla zihlala isikhathi esifushane, kepha ukufakelwa umnkantsha wethambo kungadala izinkinga. Amathuba akho okuthuthukisa lezi zinkinga ancike ezintweni eziningana, kufaka phakathi:

• iminyaka yakho
• impilo yakho yonke
• isifo olashelwa sona
• uhlobo lokufakelwa oselutholile

Izinkinga zingaba mnene noma zibe zimbi kakhulu, futhi zingafaka:

• isifo se-graft-versus-host (GVHD), okuyisimo lapho amaseli abanikeli ahlasela umzimba wakho
• ukwehluleka kokuxhunyelelwa, okwenzeka lapho amangqamuzana atshalwe kabusha engaqali ukukhiqiza amaseli amasha njengoba kuhlelwe
• ukopha emaphashini, ebuchosheni nakwezinye izingxenye zomzimba
• I-cataract, ebonakala ngokugcwala ku-lens yeso
• ukulimala ezithweni ezibalulekile
• ukuqala ukuya esikhathini
• i-anemia, eyenzeka lapho umzimba ungakhiqizi amaseli abomvu ngokwanele
• izifo
• isicanucanu, isifo sohudo, noma ukuhlanza
• i-mucositis, okuyisimo esidala ukuvuvukala nobuhlungu emlonyeni, emphinjeni nasesiswini

Khuluma nodokotela wakho nganoma yikuphi ukukhathazeka ongase ube nakho. Bangakusiza ukukala ubungozi nezinkinga ngokuqhathaniswa nezinzuzo ezingaba khona zale nqubo.

Izinhlobo Zokufakelwa Kwethambo Lamathambo

Kunezinhlobo ezimbili ezinkulu zokufakelwa komnkantsha wamathambo. Uhlobo olusetshenzisiwe luzoya ngesizathu sokuthi udinga ukufakelwa kabusha.

Ukufakelwa kwe-Autologous

Ukufakelwa kwe-Autologous kufaka ukusetshenziswa kwamaseli omuntu uqobo. Ngokuvamile kufaka ukuvuna amaseli akho ngaphambi kokuqala ukwelashwa okulimazayo kumaseli afana ne-chemotherapy noma i-radiation. Ngemuva kokwelashwa, amaseli akho abuyiselwa emzimbeni wakho.

Lolu hlobo lokufakelwa alutholakali ngaso sonke isikhathi. Ingasetshenziswa kuphela uma unomnkantsha onempilo. Kodwa-ke, yehlisa ubungozi bezinkinga ezithile ezinkulu, kufaka phakathi i-GVHD.

Ukufakelwa kwe-Allogeneic

Ukufakelwa kwe-allogeneic kubandakanya ukusetshenziswa kwamaseli avela kumnikeli. Umnikeli kufanele abe umdlalo osondelene nowofuzo. Imvamisa, isihlobo esisebenzisanayo yisona esingcono kakhulu, kepha ukufana kofuzo kungatholakala nakwirejista yabanikeli.

Ukufakelwa kwe-allogeneic kuyadingeka uma unesimo esilimaze amaseli akho omnkantsha. Kodwa-ke, banengozi ephezulu yezinkinga ezithile, njenge-GVHD. Futhi kuzodingeka ukuthi ufakwe emithini yokwelapha ukucindezela amasosha akho omzimba ukuze umzimba wakho ungahlaseli amaseli amasha. Lokhu kungakushiya usengozini yokugula.

Impumelelo yokufakelwa kabusha kwe-allogeneic incike ekutheni amaseli abanikeli afana kanjani kakhulu nawe.

Ungakulungiselela Kanjani Ukufakelwa Umongo Wethambo

Ngaphambi kokufakelwa kabusha, uzohlolwa okuningi ukuthola ukuthi yiluphi uhlobo lwamaseli omnkantsha owadingayo.

Ungathola futhi imisebe noma i-chemotherapy ukubulala wonke amangqamuzana omdlavuza noma amangqamuzana omnkantsha ngaphambi kokuthola amangqamuzana amasha.

Ukufakelwa komnkantsha wethambo kuthatha isonto lonke. Ngakho-ke, kufanele wenze amalungiselelo ngaphambi kweseshini yakho yokuqala yokufakelwa kabusha. Lokhu kungafaka:

• izindlu eziseduze nesibhedlela zabathandekayo bakho
• ukumbozwa komshuwalense, ukukhokhwa kwezikweletu, nokunye ukukhathazeka kwezezimali
• ukunakekelwa kwezingane noma izilwane ezifuywayo
• ukuthatha ikhefu lezokwelapha emsebenzini
• ukupakisha izingubo nezinye izidingo
• ukuhlela ukuhlela ukuya nokubuya esibhedlela

Ngesikhathi sokwelashwa, amasosha akho omzimba azothikamezeka, athinte amandla awo okulwa nezifo. Ngakho-ke, uzohlala esigabeni esikhethekile sesibhedlela esibekelwe abantu abathola ukufakelwa umnkantsha wethambo. Lokhu kunciphisa ubungozi bokuchayeka kunoma yini engadala ukutheleleka.

Unganqikazi ukuletha uhlu lwemibuzo ozoyibuza udokotela wakho. Ungabhala phansi izimpendulo noma ulethe umngani azokulalela futhi athathe amanothi. Kubalulekile ukuthi uzizwe ukhululekile futhi uzethembile ngaphambi kwenqubo nokuthi yonke imibuzo yakho iphendulwe kahle.

Ezinye izibhedlela zinabeluleki abakhona ukukhuluma neziguli. Inqubo yokufakelwa kabusha ingakhathaza ngokomzwelo. Ukukhuluma nochwepheshe kungakusiza kule nqubo.

Kwenziwa Kanjani Ukufakelwa Komongo Wethambo

Lapho udokotela wakho ecabanga ukuthi usukulungele, uzoba nokufakelwa kabusha. Inqubo ifana nokumpontshelwa igazi.

Uma ufakelwa i-allogeneic, amaseli omnkantsha azovunwa kumnikeli wakho usuku noma izinsuku ezimbili ngaphambi kwenqubo yakho. Uma amaseli akho esetshenziswa, azokhishwa ebhange le-stem cell.

Amaseli aqoqwa ngezindlela ezimbili.

Ngesikhathi sokuvunwa komnkantsha wamathambo, amaseli aqoqwa kuwo womabili amathambo ngenaliti. Ungaphansi kwe-anesthesia yale nqubo, okusho ukuthi uzobe ulele futhi ungenabo ubuhlungu.

Leukapheresis

Ngesikhathi se-leukapheresis, umuntu onikelayo unikezwa izibhamu ezinhlanu ukusiza amangqamuzana esiqu asuke emnkantsheni wethambo aye egazini. Igazi bese lidonswa ngentambo efakwa emthanjeni (IV), bese umshini uhlukanisa amaseli egazi amhlophe aqukethe ama-stem cells.

Kuzofakwa inaliti ebizwa ngokuthi i-central venous catheter, noma itheku, engxenyeni engakwesokudla esifubeni sakho. Lokhu kuvumela uketshezi oluqukethe amangqamuzana amasha esiqu ukuba agelezele ngqo enhliziyweni yakho. Amaseli esiqu abe esehlakazeka kuwo wonke umzimba wakho. Zigeleza ngegazi lakho nakumnkantsha wethambo. Zizosungulwa lapho futhi ziqale ukukhula.

Itheku lishiywa likhona ngoba ukufakelwa umnkantsha wethambo kwenziwa ngezikhathi ezithile izinsuku ezimbalwa. Izikhathi eziningi zinikeza amangqamuzana ama-stem amasha ithuba elihle lokuzihlanganisa emzimbeni wakho. Leyo nqubo yaziwa ngokuthi yi-engraftment.

Ngaleli chweba, uzothola nokumpontshelwa igazi, uketshezi, kanye nezakhamzimba. Ungadinga imishanguzo ukulwa nezifo futhi usize umnkantsha omusha ukuba ukhule. Lokhu kuncike ekutheni uziphatha kanjani izindlela zokwelapha.

Ngalesi sikhathi, uzobhekwa ngokucophelela nganoma yiziphi izinkinga.

Yini Ongayilindela Ngemuva Kokufakelwa Komongo Wethambo

Impumelelo yokufakelwa umnkantsha wethambo incike kakhulu ekutheni lowo onikelayo nalowo owamukelayo bafanelana kangakanani nezakhi zofuzo. Kwesinye isikhathi, kungaba nzima kakhulu ukuthola umdlalo omuhle phakathi kwabaxhasi abangahlobene.

Isimo se-engraftment yakho sizobhekwa njalo. Ngokuvamile kuqedile phakathi kwezinsuku eziyi-10 nezingama-28 ngemuva kokufakelwa kokuqala. Isibonakaliso sokuqala se-engraftment yisibalo samaseli amhlophe esikhulayo. Lokhu kukhombisa ukuthi ukufakelwa sekuqala ukwenza amangqamuzana egazi amasha.

Isikhathi esivamile sokutakula ukufakelwa umnkantsha cishe izinyanga ezintathu. Kodwa-ke, kungathatha unyaka ukuthi ululame ngokuphelele. Ukubuyiselwa emuva kuncike ezintweni eziningi, kufaka phakathi:

• isimo esilashwa
• ukwelashwa ngamakhemikhali
• imisebe
• umdlalo wabanikeli
• lapho ukufakelwa khona kwenziwa

Kukhona amathuba okuthi ezinye zezimpawu ohlangabezana nazo ngemuva kokufakelwa zizohlala nawe impilo yakho yonke.